The primary objective is to establish the effect of a unilateral task performed with the non-paretic arm on dynamic joint admittance and reflex gain of the wrist of the paretic arm in stroke patients compared to the effect of a unilateral task on…
ID
Source
Brief title
Condition
- Central nervous system vascular disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Dynamic joint admittance (comprised of inertia, viscosity and stiffness) and
reflex gain of the wrist joints.
Secondary outcome
Demographics: date of birth, gender, hand dominance.
Clinical phenotype: type of stroke (ischemic or hemorrhagic), lesion side, time
after stroke, voluntary muscle strength of wrist flexors and extensors (0-5
Medical Research Council (MRC) scale), disturbances in gnostic sensibility.
Background summary
Upper extremity dysfunction is a major problem after stroke. Therapeutic
interventions for upper extremity dysfunction after stroke can be broadly
divided in unilateral arm training, such as constraint-induced movement therapy
(CIMT), and bilateral arm training (BAT). Insufficient evidence is available
for targeted therapy for the individual patient, urging the need for an
objective method to rationalize diagnostics and therapy choice. The strength
(and location) of neural interaction may determine the success of either
treatment. We will apply haptic manipulators to quantify bimanual wrist joint
admittance and reflexive interactions in controls and patients. With this study
we aim to reveal whether the bimanual neural interaction between controls and
patients differs in strength and variability. The method may result in a fast
and functional clinical method to distinguish which patient is most likely to
benefit from BAT.
Study objective
The primary objective is to establish the effect of a unilateral task performed
with the non-paretic arm on dynamic joint admittance and reflex gain of the
wrist of the paretic arm in stroke patients compared to the effect of a
unilateral task on the contra lateral arm in controls.
The secondary objective is to determine the differences within the patient
group and relate these to patient characteristics, such as hand dominancy,
lesion side and function.
Study design
Case-control observational study.
Study burden and risks
Patients will undergo a short clinical examination for clinical phenotyping
focused on muscle strength and sensibility and functional disorders in the
lower arm. The total duration of the trials will be approximately 60 minutes.
There are no specific risks associated with participation.
Albinusdreef 2
Leiden 2333 ZA
NL
Albinusdreef 2
Leiden 2333 ZA
NL
Listed location countries
Age
Inclusion criteria
1. Unilateral stroke
2. Paresis of the affected arm (NIHSS 1-2, visible active wrist extension possible)
3. six months to five years post stroke
4. Age above 18 years
Exclusion criteria
1. Shoulder-hand syndrome post-stroke
2. Wrist paralysis
3. Severe contractures of wrist and/or fingers post-stroke
4. History of wrist disorders, such as traumata and rheumatic diseases
5. History of other neurologic diseases that affect muscle strength and sensory feedback in the arms
6. Unable to understand and follow the instructions
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL41580.058.12 |